Full Name *

Email *

Phone *

Organization (If Applicable)

Landline (If Applicable)

Issue *

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Number of Chairs to Repair *

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Purchase Date *

Preferred Upholstery Material

VAT Number (If Applicable)

Invoice Number

Chair Model

Tell Us More About The Problem *

Address

Street Address *

City *

Postal Code *

Suburb *

Province *

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Photo of Chair *

Clear Photo of Guarantee Sticker *

You can find the sticker below the seat / mechanism on your chair. 

Close Up Photo of Problem Area *